The nurse is caring for a 4-month-old with a history of ventricular septal defect. The infant is admitted for failure to thrive. What supportive measure would the nurse anticipate in an infant with congestive heart failure?
increased caloric density of Formula
Oxygen therapy to ensure oxygen saturation is > 98%
Sedatives to keep the infant from crying
Emergent surgical correction of the defect
The Correct Answer is A
Infants with congenital heart defects, including VSD, may have increased caloric needs due to the added work of their hearts. Congestive heart failure can lead to poor weight gain and failure to thrive. Therefore, increasing the caloric density of the formula is a common approach to providing the necessary nutrition for growth and development. This can be achieved by using specialized high-calorie infant formulas or fortifying breast milk.
The other options are not the primary supportive measures for an infant with congestive heart failure in this context:
B. Oxygen therapy to ensure oxygen saturation is > 98%: While oxygen therapy may be necessary for infants with congenital heart defects, it is not the primary supportive measure to address failure to thrive. Oxygen therapy primarily aims to ensure adequate oxygenation but does not directly address caloric intake.
C. Sedatives to keep the infant from crying: The use of sedatives is not a typical approach to managing congestive heart failure in infants. Addressing the underlying cause, optimizing nutrition, and providing supportive care are more appropriate strategies.
D. Emergent surgical correction of the defect: Surgical correction of a VSD is typically considered for specific indications, such as significant hemodynamic compromise, but it is not the first-line intervention for all cases of VSD, especially if the primary concern is failure to thrive. Treatment decisions for VSD are made based on the specific clinical presentation and severity of the defect.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["480"]
Explanation
To calculate the total volume the patient will receive, you can use the formula:
Total Volume = Rate x Time
In this case, the rate is 20 mL/hr, and the time is 24 hours. Now, calculate:
Total Volume = 20 mL/hr x 24 hr = 480 mL
So, the patient will receive a total of 480 mL of the 0.9% NS solution.
Correct Answer is B
Explanation
Assessing pulses is a critical step immediately after a cardiac catheterization procedure because it helps determine the adequacy of blood flow to the extremities and any potential vascular complications. Cardiac catheterization involves the insertion of a catheter through blood vessels, which can temporarily affect blood flow. Checking pulses in the affected limb (e.g., the leg or arm where the catheter was inserted) is essential to detect any signs of vascular compromises, such as decreased or absent pulses, which could indicate complications like arterial thrombosis or embolism. Prompt recognition of such issues is crucial for timely intervention to prevent potential complications or limb damage.
The other options are also important but should be addressed after the initial assessment of pulses:
A. Pain: Assessing pain is important, but it should come after checking pulses. If the child reports pain, it could indicate discomfort or complications related to the procedure, which may require further evaluation and intervention.
C. Catheterization report: Reviewing the catheterization report is necessary for a comprehensive understanding of the procedure and its findings, but it is not the immediate priority when assessing the child's post-procedure condition.
D. Hemoglobin and hematocrit levels: Checking hemoglobin and hematocrit levels is important to monitor for potential bleeding complications that may occur during or after the procedure, but it is a secondary assessment compared to evaluating pulses. If there are significant changes in these levels, they may require further investigation and intervention.
In summary, assessing pulses is the initial priority after a cardiac catheterization procedure in order to promptly identify any vascular issues or complications that need immediate attention.
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